Venous lactate improves the prediction of in-hospital adverse outcomes in normotensive pulmonary embolism
| Autor: | Burkert Pieske, Karl Stangl, Charlotta F. Pagel, Matthias Ebner, Veli-Pekka Harjola, Carmen Sentler, Stavros Konstantinides, Gerd Hasenfuß, Mareike Lankeit, Markus H. Lerchbaumer, Héctor Bueno |
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| Přispěvatelé: | Ministerio de Economía y Competitividad (España), Fundación ProCNIC, German Federal Ministry of Education and Research, HUS Emergency Medicine and Services, University of Helsinki, Helsinki University Hospital Area |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adverse outcomes Venous lactate 030204 cardiovascular system & hematology GUIDELINES DIAGNOSIS 03 medical and health sciences THROMBOEMBOLISM 0302 clinical medicine Internal medicine MANAGEMENT Internal Medicine medicine Humans In patient Lactic Acid Prospective Studies 030212 general & internal medicine Prospective cohort study Risk stratification RISK Venipuncture business.industry Biomarker ARTERIAL Prognosis medicine.disease EUROPEAN-SOCIETY Hospitals 3. Good health Peripheral Pulmonary embolism 3121 General medicine internal medicine and other clinical medicine Cardiology Biomarker (medicine) Pulmonary Embolism business TASK-FORCE |
| Zdroj: | Repisalud Instituto de Salud Carlos III (ISCIII) |
| ISSN: | 0953-6205 |
| DOI: | 10.1016/j.ejim.2021.01.021 |
| Popis: | Arterial lactate is an established risk marker in patients with pulmonary embolism (PE). However, its clinical applicability is limited by the need of an arterial puncture. In contrast, venous lactate can easily be measured from blood samples obtained via routine peripheral venepuncture. We investigated the prognostic value of venous lactate with regard to in-hospital adverse outcomes and mortality in 419 consecutive PE patients enrolled in a single-center registry between 09/2008 and 09/2017. An optimised venous lactate cut-off value of 3.3 mmol/l predicted both, in-hospital adverse outcome (OR 11.0 [95% CI 4.6-26.3]) and all-cause mortality (OR 3.8 [95%CI 1.3-11.3]). The established cut-off value for arterial lactate (2.0 mmol/l) and the upper limit of normal for venous lactate (2.3 mmol/l) had lower prognostic value for adverse outcomes (OR 3.6 [95% CI 1.5-8.7] and 5.7 [95% CI 2.4-13.6], respectively) and did not predict mortality. If added to the 2019 European Society of Cardiology (ESC) algorithm, venous lactate |
| Databáze: | OpenAIRE |
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